From the Research
Dyshidrotic eczema should be treated with potent topical corticosteroids, such as betamethasone or clobetasol, applied once or twice daily for 1-2 weeks to reduce inflammation and itching, as this approach has been shown to be effective in managing the condition 1.
Treatment Overview
Dyshidrotic eczema is a skin condition characterized by small, intensely itchy blisters on the edges of the fingers, toes, palms, and soles of the feet. The goal of treatment is to reduce inflammation, itching, and prevent further flare-ups.
Topical Corticosteroids
Topical corticosteroids are the first-line treatment for dyshidrotic eczema. According to a study published in The Cochrane database of systematic reviews 1, potent topical corticosteroids are probably more effective than mild topical corticosteroids in treating eczema flare-ups. The study found that applying potent topical corticosteroids once or twice daily does not decrease the number of participants achieving treatment success compared to more frequent application.
Application and Duration
The application of topical corticosteroids should be guided by the fingertip unit method, as described in a study published in the American family physician 2. This method involves applying a small amount of medication, equivalent to the amount that can be squeezed from the tip of the index finger to the crease of the distal interphalangeal joint, to cover approximately 2% of the body surface area. The duration of treatment should be limited to 1-2 weeks for potent topical corticosteroids, as prolonged use can increase the risk of adverse effects.
Additional Measures
In addition to topical corticosteroids, other measures can help manage dyshidrotic eczema, including:
- Moisturizing regularly with fragrance-free emollients to maintain skin barrier function
- Avoiding known triggers such as nickel, cobalt, certain foods, stress, and excessive hand washing
- Soaking affected areas in cool water with colloidal oatmeal to provide temporary relief
- Considering maintenance therapy with tacrolimus 0.1% ointment or pimecrolimus 1% cream twice daily for chronic cases
- Referring severe cases to a specialist for consideration of phototherapy (UVB light) or oral immunosuppressants like cyclosporine.